In this case, we placed a co-axial needle under CT fluoroscopy via an anterior approach. The mass displaces lung and pleura laterally, and this is where the mass was accessed. While traversing the para-sternal region, the internal mammary artery should be avoided. Once the needle is in the mass, the stylet is removed and multiple core samples can be obtained using a standard biopsy gun. The co-axial system is removed and post-procedure scan is obtained to rule out pneumothorax.